Healthcare Provider Details

I. General information

NPI: 1982738738
Provider Name (Legal Business Name): CENTER FOR SLEEP AND LUNG DISORDERS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2007
Last Update Date: 02/06/2024
Certification Date: 02/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

918 ROLLING ACRES RD STE 1
LADY LAKE FL
32159-5026
US

IV. Provider business mailing address

PO BOX 1480
LADY LAKE FL
32158-1480
US

V. Phone/Fax

Practice location:
  • Phone: 352-391-5500
  • Fax: 352-391-5501
Mailing address:
  • Phone: 352-391-5500
  • Fax: 352-391-5501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number97830
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number97830
License Number StateFL

VIII. Authorized Official

Name: ANUPAMA UPADYA
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 352-552-5685